| NPI | 1407696347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA70071462) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA70071462) |
| 363A00000X Physician Assistant (Licence: WA PA70071462) | |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2026-03-02 |